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Pretending orgasm during sexual intercourse: correlates in a sample of young adult women.

Although popular media have addressed the issue of women pretending orgasm during sexual intercourse, the research literature on the phenomenon is sparse. In the current study, 161 young adult women provided data regarding lifetime sexual experience, objective and subjective physical attractiveness, sexual attitudes (erotophobia-erotophilia), sexual esteem, and general tendencies toward self-monitoring of expressive behavior in social situations. Overall, more than one-half of the women reported having pretended orgasm during sexual intercourse. In univariate analyses, the "pretenders" and "non-pretenders" did not differ in experimenter-rated facial attractiveness, self-rated body attractiveness, or general self-monitoring. However, pretenders were significantly older; viewed themselves as facially more attractive, reported having had first intercourse at a younger age; reported greater numbers of lifetime intercourse, fellatio, and cunnilingus partners; and scored higher on measures of sexual esteem and erotophilia. In multivariate analyses, only sexual esteem was uniquely related to having pretended orgasm. The findings are discussed with regard to possible explanations and implications, as well as directions for future research.

Adult↗

Sexual and demographic risk factors for herpes simplex virus type 2 according to schooling level among Mexican youths.

BACKGROUND: Herpes simplex virus type 2 (HSV-2), the agent causing one of the most common sexually transmitted infections in sexually active individuals, is currently considered a public health problem. In Mexico, there have been no population-based studies of the prevalence and factors associated with HSV-2 infection among young students. GOAL: The goal was to measure HSV-2 seroprevalence and identify possible associated factors among students in the state of Morelos, Mexico. STUDY DESIGN: Through a cross-sectional population-based study involving students at 92 schools in the state of Morelos, Mexico, 898 students aged 11 to 24 years old were identified. All of them reported they had already initiated sexual activity and provided a blood sample to detect the presence of anti-HSV-2 antibodies through the Western blot technique. The association between risk factors and HSV-2 was evaluated through multiple logistic regression analysis with stratification by sex and schooling level. RESULTS: In the population under study, the prevalence of HSV-2 seropositivity was 5.7% (51/898), and the ratio of females to males was 2:1. The prevalence of consistent condom use overall was 22.6% among the 898 students. For students in Morelos State, Mexico, the HSV-2 seroprevalence was higher among the youngest female students (9.5% among junior high school versus 3.3% among university students; P<0.001). The main factors associated with HSV-2 infection were sex (for females the risk was 2.2 times higher than for males; 95% CI, 1.2-3.9); junior high school status (2.5 times higher risk than university students (95% CI, 1.1-6.0); and having had same-sex sexual intercourse (3.5 times higher risk; 95% CI, 1.4-8.9). CONCLUSION: In contrast with other reports, the HSV-2 seroprevalence was higher among younger people. This finding can be explained by a cohort effect of more exposition to behavioral risks, particularly an earlier age at first intercourse and very low use of condoms among youngest students. Longitudinal surveys about serological responses to HSV-2 infection in different age groups are warranted.

Adolescent↗

The relationship between early development and psychosexual behaviors in adolescent females.

The relationship between early sexual maturation and the psychosexual behaviors of dating and sexual intercourse was investigated using a national sample of adolescent females aged 15 to 19. Among both black and nonblack subjects, early-maturing girls were more likely to have experienced earlier dating and coital onset than were their later-maturing peers. Blacks experienced menarche and first intercourse at earlier ages, yet dating onset at later ages. Early menarche was also associated with marriage at an early age for nonblacks, but not for blacks. These racial differences were explained in terms of diverse socialization patterns or cultural expectations. For both blacks and nonblacks, those with earlier coital experience were found to have had menarche and dating onset at earlier ages.

Adolescent↗

Acculturation as a predictor of the onset of sexual intercourse among Hispanic and white teens.

OBJECTIVE: To investigate ethnic differences in onset of sexual intercourse among Hispanic/Mexican American and white adolescents based on acculturation. DESIGN/METHODS: Preprogram survey data from 7270 Hispanic or white teens in 7th to 12th grade involved in the Arizona Abstinence-Only Education Program were used to predict the probability of onset of sexual intercourse based on age, sex, family structure, program location, religiosity, free school lunch, grades, rural residence, acculturation, and ethnicity. Specific attention was given to the influence of acculturation among Hispanic teens. The primary language spoken by the respondents (English, Spanish, or both) was used as a proxy measure for acculturation. RESULTS: Hispanic youth were at a greater risk for experiencing onset of intercourse than white youth, while controlling for all other predictors (odds ratio [OR], 1.40 [95% confidence interval (CI), 1.21-1.63]). This risk was amplified for highly acculturated Hispanic teens (OR, 1.69 [95% CI, 1.43-1.99]). However, less acculturated Hispanic youth were actually less likely to have experienced first intercourse than white youth (OR, 0.59 [95% CI, 0.42-0.82]), English-speaking Hispanic youth (OR, 0.35 [95% CI, 0.25-0.49]), or bilingual Hispanic youth (OR, 0.45 [95% CI, 0.31-0.64]). CONCLUSIONS: Low acculturation emerges as a significant protective factor while controlling for other social and cultural factors, in spite of the increased risk of initiating sexual intercourse for Hispanic teens overall. Hispanic Spanish speakers were least likely to have initiated intercourse, while Hispanic English speakers were the most likely.

Acculturation↗

Fertility and contraceptive use among young adults in Harare, Zimbabwe.

In 1986, a survey of young adults aged 14-24 in Harare, Zimbabwe obtained information about their knowledge, attitudes, and sexual behavior. Most adolescent childbearing took place within marriage, although sexual intercourse was generally initiated before marriage. Knowledge of family planning was high, but contraceptive use lagged behind knowledge. Fewer than half of the respondents had talked to an elder about family planning, sex, or pregnancy. Fourteen percent of young women who were unmarried at the time of first intercourse used contraceptives, compared to 18 percent of young unmarried men. Current contraceptive use among sexually active unmarried youths was 36 percent among women and 29 percent among men. One consequence of low contraceptive use was a high number of unwanted premarital pregnancies. Twenty-nine percent of the women had been pregnant; those not married at the time they got pregnant generally got married soon after. Of the girls who got pregnant while in school, 90 percent had to drop out of school. A second consequence of low contraceptive use is an increased risk of transmission of STDs and AIDS among the youth of Harare.

Adolescent↗

The association of consensual sexual intercourse during childhood with adolescent health risk and behaviors.

OBJECTIVE: The association of childhood sexual intercourse, excluding sexual abuse, with adolescent health and risk behaviors was examined using the urban component of a statewide study on adolescent health, risky behaviors, and resiliency factors. METHODOLOGY: A specialized cohort design was used to derive a two-group sample. Index cases consisted of all adolescents who indicated that they had first intercourse at or before age 10 years, and controls were adolescents who either had not yet had intercourse or had done so at age 16 years or older. To avoid confounding with issues of sexual abuse, all adolescents who also indicated a history of sexual abuse on the survey were removed from the analysis, so that the comparison could focus on health and behavioral correlates of respondents who did not define their childhood sexual intercourse as constituting abuse. Comparisons were conducted separately for girls and boys. RESULTS: A significantly greater proportion of index cases than controls indicated problem substance use by parents, poor school performance, gang involvement, frequent and unprotected sexual intercourse, history of pregnancy involvement, desire to leave the home, history of mental health treatment, emotional distress, and suicidal involvement. Logistic regression revealed significant group differences including academic risk, gang involvement, frequency of sexual intercourse, and history of mental health treatment. Correct group classification with the logit model was approximately 90% for both girls and boys. CONCLUSIONS: The results underscore the importance of childhood sexual intercourse as an indicator of other health-compromising behaviors and risk factors. Clinicians should be alert to this clustering of risk behaviors in their psychosocial assessment of young people.

Adolescent↗

Teenage fertility and life chances.

Teenage mothers and their children face poorer prospects in life than do women who delay motherhood until later in life. Moreover, patterns of early childbearing tend to be repeated in subsequent generations. Therefore, an understanding of the factors associated with early fertility is important for the prevention of adverse consequences. This paper uses data from the National Survey of Sexual Attitudes and Lifestyles to explore these associations. Early sexual intercourse is an important predictor of early fertility, as is poor educational attainment, although it is not clear to what extent pregnancy acts to thwart academic ambitions, or to what extent poor educational performance leads to a need to seek personal fulfilment in other than academic goals. Thus, interventions designed to influence age at first intercourse and to improve educational performance both have potential in terms of impacting on teenage pregnancy rates. Family background also exerts a powerful influence on teenage fertility. Young people for whom one or both parents are absent are more likely to become parents early in life. However, the most important factor of family life determining the chances of teenage motherhood appear to be the quality of communication about sexual matters with the home. In terms of outcomes, teenage mothers are more likely to live in social housing, are less likely to be in paid employment and have larger than average sized families. Certain areas of the country, notably the older, run-down industrial areas, have higher rates of teenage motherhood than the newer, more prosperous areas. Because most of these effects are independent of one another, there is potential merit in intervening to prevent unintended conception at several points in a young woman's life. Primary preventive efforts are needed to reduce the rates at which teenage pregnancy occurs in this country. Yet, if the cycle of deprivation that means the children of young mothers themselves enter parenthood early is to be broken, then efforts must also be made to mitigate the effects of teenage fertility for both mother and child.

Adolescent↗

Demographic and clinical factors as determinants of serum levels of prostate specific antigen and its derivatives.

BACKGROUND: To characterise the association between demographic and clinical factors and levels of total prostate specific antigen (tPSA) and its molecular derivatives complexed PSA (cPSA), free PSA (fPSA) and the ratio of free to total PSA (%fPSA)] in New Zealand Maori, Pacific Islanders and Europeans, in order to determine whether reported ethnic differences in PSA can be explained by lifestyle and social factors. MATERIALS AND METHODS: Demographic and clinical factors were examined in relation to tPSA, fPSA and cPSA levels, in 1405 Maori, Pacific Island and New Zealand European men with no clinical evidence of prostate cancer, in the Wellington region of New Zealand. Any associations between levels of PSA and PSA derivatives and body mass index, smoking status, family cancer history, non-steroidal anti-inflammatory/vitamin supplement usage, number of sexual partners, age at first intercourse, previous vasectomy, marital/partnership status, educational level and socioeconomic status were investigated by backwards stepwise regression analysis, correcting for age, ethnicity and urinary symptoms. RESULTS: Not being married/partnered was associated with increased tPSA, fPSA and cPSA. tPSA and cPSA decreased with regular non-steroidal anti-inflammatory use. cPSA was decreased in subjects with a first degree relative with any form of cancer. tPSA and fPSA were decreased if the body mass index was > 34. fPSA and %fPSA were decreased in current and former smokers. CONCLUSION: Demographic and clinical factors appear to have a significant effect on levels of PSA and its various derivatives and may account for previously observed ethnic differences. It is important that these associations are taken into account when comparing individual PSA results with standard reference ranges.

Adult↗

Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20-44 years: the UK National Case-Control Study of Cervical Cancer.

We report results on risk factors for invasive squamous cell and adenocarcinomas of the cervix in women aged 20-44 years from the UK National Case-Control Study of Cervical Cancer, including 180 women with adenocarcinoma, 391 women with squamous cell carcinoma and 923 population controls. The risk of both squamous cell and adenocarcinoma was strongly related to the lifetime number of sexual partners, and, independently, to age at first intercourse. The risk of both types of cervical cancer increased with increasing duration of use of oral contraceptives, and this effect was most marked in current and recent users of oral contraceptives. The risk of squamous cell carcinoma was associated with high parity and the risk of both squamous cell and adenocarcinoma increased with early age at first birth. Long duration smoking (20 or more years) was associated with a two-fold increase in the risk of squamous cell carcinoma, but smoking was not associated with the risk of adenocarcinoma. Further studies are needed to confirm the suggestion from this and other studies of differences in risk related to smoking between squamous cell and adenocarcinomas of the cervix.

Adenocarcinoma↗

Employment and health-risk behaviors among pregnant adolescents.

STUDY OBJECTIVE: To compare health-risk behaviors, maternal, and neonatal outcomes of pregnant adolescents less than 18 years old who reported employment more than 15 hours per week with those who did not report working. We hypothesized that working teens compared with nonworking adolescents would report higher rates of health-risk behaviors. METHODS: A structured interview was conducted at the first prenatal visit and the medical chart was reviewed to extract pregnancy (pregnancy-induced hypertension, preterm labor with hospitalization, and preterm delivery) and neonatal outcomes (low birthweight, small for gestational age, and admission to the neonatal intensive care unit). The study was conducted at an outpatient maternal and child health clinic at a university teaching hospital. A total of 384 white (n=111), African American (n=151), and Mexican American (n=99) adolescents, aged 12 to 17 years, who initiated care between January 2, 1992, and December 31, 1994, and delivered an infant at our institution were consecutively sampled. A structured interview assessed various health-risk behaviors including age at first intercourse, substance use (tobacco, alcohol, and other illicit drug use), and number of sexual partners. Medical records were reviewed to obtain information on pregnancy complications (pregnancy-induced hypertension, preterm delivery, and preterm labor with hospitalization) and negative birth outcomes (infant birthweight and neonatal intensive care admission). RESULTS: Controlling for chronological age, logistic regression analyses found that adolescents reporting employment at their first prenatal visit (n=40) compared with those not employed at this visit (n=331) were more likely to be characterized by school enrollment, higher economic status, partner employment, partner alcohol use, and a longer relationship with the father of their baby. Multivariate logistic regression found that employed females were 4.6 times more likely to deliver a small-for-gestational-age infant. CONCLUSIONS: Employment reported at the time of the first prenatal visit does not appear to be associated with an increase in health-risk behaviors or obstetric complications, but a relationship between working more than 15 hours and small-for-gestational-age delivery was detected.

Adolescent↗

Risks among youths who have multiple sisters who were adolescent parents.

CONTEXT: Past research has revealed that having a sister who gave birth as a teenager is associated with increases in young people's likelihood of engaging in risky sexual behavior. To date, however, no study has determined if having several sisters who were adolescent mothers further raises youths' chances of engaging in risky activities. METHODS: Data were collected from 1,510 predominantly Hispanic and black 11-17-year-olds in a California program for youths who have at least one pregnant or parenting sister. Correlational analyses, analyses of variance and regression analyses were conducted to assess the effects of having multiple teenage parenting sisters on a variety of outcomes that are known risk factors for teenage pregnancy RESULTS: Twenty-four percent of participants had two or more sisters who had given birth as teenagers. The likelihood of having multiple adolescent parenting sisters was greatest in large families, but was unrelated to youths' other background characteristics. In analyses controlling for background factors, females with many parenting sisters had increased levels of behavioral problems (school problems, drug or alcohol use, and delinquent behavior) and an elevated likelihood of being sexually experienced. Having lived with two or more parenting sisters (as opposed to having lived with only one) was related to more permissive sexual and childbearing attitudes among young women and to earlier first intercourse among young men. Males with a sister who gave birth at a young age had elevated levels of delinquent behavior and promiscuous sexual behavior. CONCLUSIONS: As the number of teenage parenting sisters rises, youths'--particularly females'--risk of pregnancy involvement increases beyond the level associated with having only one teenage parenting sister. Screening for the number, living situation and age at first birth of parenting sisters is likely to be useful for programs seeking to identify youths at high risk of an early pregnancy.

Adolescent↗

Human papillomavirus frequency of women at low risk of developing cervical cancer: a preliminary study from a Turkish university hospital.

PURPOSE: To investigate the frequency of human papillomavirus (HPV) infection among low-risk women for cervical cancer in our region. METHODS: In one year period, 230 consecutive women at low risk of developing cervical cancer were enrolled to the study. HPV DNA testing was performed by Hybrid Capture-I System (HC-I) and groups were constituted by HPV-positive and HPV-negative women. A comparison of the groups according to age, obstetric history and age at the beginning of sexual intercourse was made. Statistical analysis was performed. RESULTS: The frequency rate of HPV infection was demonstrated to be 6.1% (n = 14) in our study (5.9% in women < or = 45 years and 7.7% in women > 45 years). Age-dependent differences were not observed between groups. There was no significant difference between HPV-positive and negative women regarding obstetric characteristics and mean age at first intercourse. CONCLUSION: This study provided significant information on the frequency of HPV infection of low-risk women in our region. When considered with studies performed in other countries, our study may give some help on the natural history of HPV infection and cervical squamous lesions.

Adult↗

Alcohol and condom use: a meta-analysis of event-level studies.

BACKGROUND: Although it is often assumed that drinking alcohol interferes with condom use, studies on this topic have used several different methods and have yielded inconsistent findings. By examining drinking and condom use in specific sexual encounters, the role of alcohol in influencing unprotected intercourse is targeted. GOAL: The goal of the study was to assess the relationship of alcohol use and condom use in discrete sexual encounters using meta-analysis. STUDY DESIGN: Studies in the literature were identified by computerized searches of MEDLINE and PsycINFO and hand searches of reference lists. Summary odds ratios were calculated for all analyses and for subgroups formed according to type of sexual encounter (first, most recent, most recent with a new sexual partner). RESULTS: The association of alcohol use and condom use varied by type of sexual encounter: drinking at first intercourse was associated with decreased condom use (odds ratio [OR], 0.54; 95% CI, 0.44-0.66), but drinking was unrelated to condom use in recent sexual encounters (OR, 1.04; 95% CI, 0.89-1.21) and in recent encounters with new partners (OR, 1.1; 95% CI, 0.92-1.32). CONCLUSION: Drinking is not necessarily linked to unprotected intercourse; the relationship between alcohol use and unprotected sex depends on context and sexual experience of the partners.

Adolescent↗

American Indian--Alaska Native youth health.

OBJECTIVE: To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian-Alaska Native adolescents. DESIGN: Survey. SETTING: Nonurban schools from eight Indian Health Service areas. PARTICIPANTS: A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths. MAIN OUTCOME MEASURES: revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health. RESULTS: Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use. CONCLUSIONS: American Indian-Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.

Adolescent↗

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

OBJECTIVES: The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. METHODS: This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. RESULT: 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. CONCLUSION: In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.

Adolescent↗

Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002.

OBJECTIVE: This report presents national estimates of sexual activity, contraceptive use, and births among males and females 15-19 years of age in the United States in 2002 from the National Survey of Family Growth (NSFG). Data are also presented from the 1988 and 1995 NSFGs, and from the 1988 and 1995 National Survey of Adolescent Males (NSAM). METHODS: Descriptive tables of numbers and percents are presented and interpreted. Data were collected through in-person interviews of the civilian noninstitutionalized population in the United States. Interviews were conducted with 7,643 females, 1,150 of whom were teenagers, and 4,928 males, 1,121 of whom were teenagers. RESULTS: In 2002, about 47 percent of female teenagers (4.6 million), and about 46 percent of male teenagers (4.7 million) had had sexual intercourse at least once. For never-married males, there was a significant decline from 55 percent in 1995 to 46 percent in 2002. Among never-married females, for those aged 15-17 there was a significant decline in the percent sexually experienced, and for those aged 18-19 there was no significant change. Teenagers showed increases in the use of contraceptives. About 3 out of 4 teens used a method of contraception at their first intercourse. About 91 percent of males and 83 percent of females used a method at their last (most recent) sex. Hispanic teens are most likely to have a birth before age 20 and non-Hispanic whites are least likely, with non-Hispanic black teens in the middle. CONCLUSION: This report documents findings that may be helpful in understanding trends in teen birth and pregnancy, and STD rates.

Adolescent↗

Impact on sexually transmitted disease spread of increased condom use by young females, 1987-1992.

BACKGROUND: Sexual behaviour data are crucial for understanding the spread of sexually transmitted diseases (STD). Over a period (1987-1992) in which the HIV epidemic increased public awareness of safe sexual practices, we describe predictors of condom use, changes in condom use over time, and the estimated effects of these changes on the spread of STD. METHODS: Condom use reported by females aged 18-35 years with non-cohabiting partners was analysed using data from two cross-sectional postal surveys performed 5 years apart (1987 and 1992) on two separate representative samples of 10,000 subjects aged 18-60 years living in Norway. A simple mathematical model was used to assess the effects of selection bias. A more complicated model was used to predict the effects of condom use on the prevalence of STD in a population which includes a core group of highly sexually active subjects. RESULTS: We found an increase in the prevalence of condom use in the latest intercourse from 14% to 20% with non-foreign partners and from 10% to 38% with foreign partners, from 1987 to 1992. In a logistic regression model, low frequency of intercourse, high education, one lifetime partner, and late sexual debut were predictors for condom use. Controlled for these variables, the odds ratio (OR) for condom use in 1992 versus 1987 was 1.4 (95% confidence interval [CI]: 0.9-2.0) if the partner was non-foreign, and 7.1 (95% CI: 2.5-20.5) if the partner was foreign. Not using other contraceptive methods was a strong predictor for condom use; OR = 17.4 (95% CI: 8.0-38.0). Condom use in the first intercourse with the last partner was a strong predictor for condom use in the last intercourse; OR = 19.2 (95% CI: 8.2-45.3). It appeared unlikely that the increase in condom use could be explained by response bias. The predicted reductions in STD prevalence due to the increase in condom use ranged from zero to 30% depending on consistency of use, and on the agent that is transmitted. CONCLUSIONS: Condom use among 18-35 year old women has increased over the period, particularly with foreign partners. Condoms are used primarily as contraception. The prevalences of STD with high transmission rates are not reduced by inconsistent condom use, while the prevalences of STD with low transmission rates are reduced by both consistent and inconsistent condom use. Condom use in a core group is more effective for reducing the STD prevalence than condom use in the non-core group for gonorrhoea and HIV. For chlamydial infection, condom use in the non-core group is more effective.

Adolescent↗

Before first sex: gender differences in emotional relationships and physical behaviors among adolescents in the Philippines.

CONTEXT: Early age at first sex has been identified as a risk factor for unplanned pregnancy and HIV infection. However, the emotional relationships and physical behaviors that precede first intercourse, and how they differ by sex, also may provide important cues about how to prevent sexual risk behavior. METHODS: The precoital activities of 2,051 adolescents aged 17-19 in Cebu, Philippines, are examined using 1998-2000 and 2002 data from the Cebu Longitudinal Health and Nutrition Survey. The timing and tempo of emotional relationships and physical behaviors for males and females are described. Cox proportional hazards models are used to identify the characteristics associated with age at first sex. RESULTS: Males engage in precoital physical behaviors and first sex at younger ages than females. Although the standard order in which the two sexes engage in emotional relationships for the first time is the same, males progress through the sequence more quickly than females. After adolescents have progressed through the sequence of emotional relationships, there is a gap of a least a year before they begin to have sex. In the multivariate analysis, rapid progression through the sequence of emotional relationships was associated with initiating sex at a younger age for females (hazard ratio, 1.5), but not for males. CONCLUSION: The period between first date and first sex experienced by both males and females provides an opportunity to ensure that adolescents have access to the information and services that will allow them to make informed choices about sexual behavior.

Adolescent↗